| Doctor Name: | MELISSA A VANAUSDOLL |
| NPI Number: | 1487633137 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PAC |
| License Number: | 103382 |
| Business Practice Address: | 7110 Lawyers Rd Mint Hill, NC - 282273906 |
| Business Phone Number: | 7045370020 |
| Business Fax Number: | 7045372144 |
| Mailing Address: | Po Box 602362, CHARLOTTE |
| State: | NC |
| Postal Code: | 282602362 |
| Phone Number: | 7045370020 |
| Fax Number: | 7045372144 |
| NPI Enumeration Date: | 01/11/2006 |
| NPI Last Update Date: | 06/21/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 103382 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |